Dr. Paul Hochfeld: This is a government giveaway to the insurance industry, with or without the public plan option.

This public plan option, at least as it’s written in HR 3200, is a lame, failed, designed-to-fail public plan option. It’s not available until 2013. When it’s available, it’s not available to people who get insurance from their employers. Those are healthy people. It’s not available to people who are upper middle class or wealthier. Those are healthy people. So the public plan option is designed to attract the sickest, most expensive people. And when it fails in 2017 or 2018, by design, the insurance industry is going to point at it and say, “See, the government can’t do healthcare.” And it’ll be the wrong lesson. And I just–this whole thing is being manipulated by the industry with our legislators being complicit in this process. [Democracy Now!]

He goes on to say that health care is a right. I’m not so sure. But aside from that, good stuff, Dr. Hochfeld.

While health care probably isn’t a right, it is, however, a moral imperative. Especially in a society that places the utmost importance on individuals’ right to Life, Liberty and the pursuit of Happiness, (assuming we still do.) “Life” depending on “survival” as much as it does, and “happiness” being as affected by “good health” as it is.

One way to persuade someone on this point would be to ask them, “If someone in your church were ill, and unable to afford treatment, and you could afford to do so, would you feel obligated to contribute to a fund to help pay their expenses?”

And, “Furthermore, knowing that your church provided this kind of help, would you feel that such a contribution was a wise investment if you knew the same would be done for you in a time of need?”

This is just an example, replace “church” with just about anything: neighborhood, family, union, club, circle of friends, motorcycle gang, maybe even town. It seems more likely that people would answer the two questions in the affirmative when conceptualizing about an affinity group they belong to. Puts the issue on a scale where it becomes tangible, where folks start thinking about it in terms of the people they see in their daily lives.

For some reason, or some combination of reasons, this feeling of solidarity toward an affinity group doesn’t translate to the nation as a whole. A Mainer might bristle at the idea of their money going to pay for some fast-driving flatlander’s or, worse, some Yankees fan’s medical bill. The rich man wonders why the fruits of his entrepreneurial expertise should benefit the health of some grunt can’t rub two quarters together. The worker doesn’t see why the cubicle denizens should get healthy off the labor of their strong back. Regional differences, religious beliefs, race, economic disparities, the urban/rural divide: all of these divisions play their part.

Living in a culture that obsesses over such divisions, there will always be a loud subset of Americans who can be relied upon to angrily resist solidarity on health care at the national level, and the media can always be counted on to amplify that dissent.

This is how politicians are able to say socialized health care, or single payer insurance, or price controls on medical services just aren’t ‘politically feasible,’ and instead reel off legislation that amounts to a bonanza for health insurance companies.

While the ideal solution I would conjure up in the anarchist utopia in my brain isn’t the single payer insurance this guy advocates, his defeatist approach toward the current health insurance legislation, with or without a so-called public option, is admirable:

Kevin Zeese: My preference would be to see this bill defeated. It does more harm than good. It empowers these corrupt corporations in ways that we don’t need. So let’s see this bill defeated and start over and make the next election about a national healthcare plan. [Democracy Now!]

You clicked the “more” button? Seriously? All that’s down here is some stuff I started to imagine about how ‘affinity group’ based health care might work. [Warning: I do not know what I am talking about when it comes to health care, Doctoring, economics, or anything else pertinent to having ideas about how to fix the health care problem.]

That’s all well and good, but, if a church group operated as the health care system currently does, providing “sick care” rather than health care, there is no way they could afford to do it. Better to take an approach that gets all of their members on regular primary care. Focus on education, awareness, prevention, on how to stay healthy, and early detection.

the group retains the services of a primary care doctor. each group member contributes on a weekly basis, to the Dr.’s salary and is entitled to regular Dr. visits, and urgent care visits when they fall ill or become injured. maybe establish an emergency/major medical fund, to take care of catastrophic medical expenses. they negotiate group rates on medications, testing, and other medical services. call it an ‘insurance union’ or ‘health co-op,’ if those terms aren’t poisoned already.

This sort of affinity group solution also has the built in benefit of an organization to establish sports teams, training groups, healthy eating support groups, to trade recipes, in general to watch out for one another.

bottom-up grassroots health care. don’t wait for the buffoons in Washington to do it for you.

And there’s another quote hanging out down here, too.

Dr. Paul Hochfeld: And we’re never going to be able to afford true universal access in this country, which is a moral imperative, until we get rid of the insurance companies. That’s the first step. It’s the first necessary step. After that, then maybe we can have a system. Then maybe we can have a healthcare administration that every decision that’s made is motivated by how do we get the most health we can for the precious money we’re spending on healthcare.

And our legislators understand this. Unfortunately, they think they need industry money to get reelected more than we think we need a healthcare system that delivers health. We don’t have a healthcare system; we’ve got a “sick care” system. The way you make money in this system is you treat sick people. There’s very little money to be made keeping healthy people healthy or keeping people with chronic diseases from stumbling into the ranks of the ill. And that’s going to continue, until we put our healthcare system in the hands of public health people. [Democracy Now!]

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I haven’t quite sorted out my reaction, but I do think basic health service is a right; most services shouldn’t be denied on any other basis than need.

In today’s world, health care might be one of those areas where centralized administration of resources is going to be most efficient, particularly if we want to retain a high-technology dimension. This is why it’s especially important that people insist on a “right” to access. It seems to me we’re headed in that direction, if slowly. It’s anybody’s opportunity to help things along.

as i say, i don’t think i’m the one to come up with a solution. but in thinking about these things, i take the approach of: how do we cut the insurance companies out of the loop? also, the key to me seems to be in primary care. how do we people their regular doctor visits so they are better equipped to stay healthy in the first place? and how do we do that humanely?

maybe some sort of co-op arrangement, (but not the kind of co-ops congress is talking about,) where folks band together for bargaining power in purchasing medication, and your high-tech medical services. takes insurance company overhead and profit out of the equation, don’t know if it puts enough downward pressure on medical services and pharmaceutical prices though…

but see what i do? i’m all over the place. i’m talking about market forces and “bargaining power” but the problem with the market and the idea of profits is that there is no accounting for human value. i told you i wasn’t the guy to figure this out.

I think your guiding concerns are dead-on. But your discussion is more forward thinking (towards a non-state alternative) than anything I’ve considered before, so I’m up for anything. I thought your conception of “affinity groups” was intriguing.

"We have no words to waste on you. When you reach out your vaunted strong hands for our palaces and purpled ease, we will show you what strength is. In roar of shell and shrapnel and in whine of machine-guns will our answer be couched. We will grind you revolutionists down under our heel, and we shall walk upon your faces. The world is ours, we are its lords, and ours it shall remain. As for the host of labor, it has been in the dirt since history began, and I read history aright. And in the dirt it shall remain so long as I and mine and those that come after us have the power. There is the word. It is the king of words—Power. Not God, not Mammon, but Power. Pour it over your tongue till it tingles with it. Power."